<!DOCTYPE html>
<html>
<head>
    <meta charset="utf-8">
    <title>投保</title>
    <link rel="stylesheet" href="/adminthemes/layui/css/layui.css" media="all">
    <!-- jQuery -->
    <script src="http://code.jquery.com/jquery-latest.js"></script>
    <!-- 注意：如果你直接复制所有代码到本地，上述css路径需要改成你本地的 -->
</head>
<body>


<form class="layui-form" action="">
    <fieldset class="layui-elem-field layui-field-title" style="margin-top: 20px;">
        <legend>投保人信息</legend>
    </fieldset>
    <div class="layui-form-item">
        <label class="layui-form-label">投保人</label>
        <div class="layui-input-inline">
            <input type="password" name="applicant_name" placeholder="请输入密码" autocomplete="off" class="layui-input">
        </div>
        <label class="layui-form-label">联系地址</label>
        <div class="layui-input-inline">
            <input type="password" name="policy_address" placeholder="请输入密码" autocomplete="off" class="layui-input">
        </div>
        <label class="layui-form-label">邮编</label>
        <div class="layui-input-inline">
            <input type="password" name="policy_zipcode" placeholder="请输入密码" autocomplete="off" class="layui-input">
        </div>
<<<<<<< HEAD
    </div>

    <div class="layui-form-item">
=======
>>>>>>> c8ad49fbaef257483e8a1589ae68fed0e83ecb45
        <label class="layui-form-label">联系电话</label>
        <div class="layui-input-inline">
            <input type="password" name="policy_mobile" placeholder="请输入密码" autocomplete="off" class="layui-input">
        </div>
        <label class="layui-form-label">组织机构代码/身份证号</label>
        <div class="layui-input-inline">
            <input type="password" name="policy_idcard" placeholder="请输入密码" autocomplete="off" class="layui-input">
        </div>
<<<<<<< HEAD
    </div>
    <fieldset class="layui-elem-field layui-field-title" style="margin-top: 20px;">
        <legend>被保险人信息</legend>
    </fieldset>
    <div class="layui-form-item">
=======
    <fieldset class="layui-elem-field layui-field-title" style="margin-top: 20px;">
        <legend>被保险人信息</legend>
    </fieldset>
>>>>>>> c8ad49fbaef257483e8a1589ae68fed0e83ecb45
        <label class="layui-form-label">被保险人</label>
        <div class="layui-input-inline">
            <input type="password" name="insurant_name" placeholder="请输入密码" autocomplete="off" class="layui-input">
        </div>
<<<<<<< HEAD
=======
        <label class="layui-form-label">与投保人关系</label>
        <div class="layui-input-inline">
            <select name="relation" autocomplete="off" class="">
                <option value="其他" selected>其他</option>
            </select>
        </div>
>>>>>>> c8ad49fbaef257483e8a1589ae68fed0e83ecb45
        <label class="layui-form-label">联系地址</label>
        <div class="layui-input-inline">
            <input type="password" name="insuranced_address" placeholder="请输入密码" autocomplete="off" class="layui-input">
        </div>
        <label class="layui-form-label">邮编</label>
        <div class="layui-input-inline">
<<<<<<< HEAD
            <input type="password" name="insuranced_zip" placeholder="请输入密码" autocomplete="off" class="layui-input">
        </div>
    </div>
    <div class="layui-form-item">
        <label class="layui-form-label">联系地址</label>
        <div class="layui-input-inline">
            <input type="password" name="insuranced_address" placeholder="请输入密码" autocomplete="off" class="layui-input">
=======
            <input type="password" name="insuranced_address" placeholder="请输入密码" autocomplete="off" class="layui-input">
        </div>
        <label class="layui-form-label">联系电话</label>
        <div class="layui-input-inline">
            <input type="password" name="insuranced_card" placeholder="请输入密码" autocomplete="off" class="layui-input">
>>>>>>> c8ad49fbaef257483e8a1589ae68fed0e83ecb45
        </div>
        <label class="layui-form-label">组织机构代码/身份证号</label>
        <div class="layui-input-inline">
            <input type="password" name="insuranced_card" placeholder="请输入密码" autocomplete="off" class="layui-input">
        </div>
        <label class="layui-form-label">投保方式</label>
        <div class="layui-input-inline">
<<<<<<< HEAD
            <input type="password" name="apply_method" placeholder="请输入密码" autocomplete="off" class="layui-input">
        </div>
    </div>
    <div class="layui-form-item">
        <label class="layui-form-label">养殖方式</label>
        <div class="layui-input-inline">
            <input type="password" name="breed_method" placeholder="请输入密码" autocomplete="off" class="layui-input">
        </div>
        <label class="layui-form-label">投保户数</label>
        <div class="layui-input-inline">
            <input type="password" name="apply_breed_count" placeholder="请输入密码" autocomplete="off" class="layui-input">
        </div>
        <label class="layui-form-label">养殖场地点及方位</label>
        <div class="layui-input-inline">
            <input type="password" name="breeding_farm_azimuth" placeholder="请输入密码" autocomplete="off" class="layui-input">
        </div>
        <#include 'InsuranceExplan.html' >
    </div>
    <div class="layui-form-item">
        <button class="layui-btn" lay-submit="" lay-filter="demo2">跳转式提交</button>
    </div>
</form>

<script src="//res.layui.com/layui/dist/layui.js" charset="utf-8"></script>
=======
            <input type="radio" checked name="apply_method" value="个体投保" autocomplete="off" class="layui-input">
            <input type="radio" name="apply_method" value="团体投保"  autocomplete="off" class="layui-input">
        </div>
        <label class="layui-form-label">养殖方式</label>
        <div class="layui-input-inline">
            <input type="radio" checked name="breed_method" placeholder="规模养殖" autocomplete="off" class="layui-input">
            <input type="radio" name="breed_method" placeholder="散养" autocomplete="off" class="layui-input">
        </div>
        <label class="layui-form-label">投保户数</label>
        <div class="layui-input-inline">
            <input type="password" name="apply_breed_count" placeholder="请输入投保户数" autocomplete="off" class="layui-input">
        </div>
        <label class="layui-form-label">养殖场地点及方位</label>
        <div class="layui-input-inline">
            <input type="password" name="breeding_farm_azimuth" placeholder="请输入养殖场地点及方位" autocomplete="off" class="layui-input">
        </div>
        <#include 'insuranceExplan.html' >
    </div>
    <div class="layui-form-item">
        <div class="layui-form-item">
            <div class="layui-input-block">
                <button class="layui-btn" lay-submit="" lay-filter="demo1">立即提交</button>
                <button type="reset" class="layui-btn layui-btn-primary">重置</button>
            </div>
        </div>
    </div>
</form>

<script src="/adminthemes/layui/layui.js"></script>
>>>>>>> c8ad49fbaef257483e8a1589ae68fed0e83ecb45
<!-- 注意：如果你直接复制所有代码到本地，上述js路径需要改成你本地的 -->
<script>
    layui.use(['form', 'layedit', 'laydate'], function(){
        var form = layui.form
            ,layer = layui.layer
            ,layedit = layui.layedit
            ,laydate = layui.laydate;

        //日期
<<<<<<< HEAD
        laydate.render({
            elem: '#date'
        });
        laydate.render({
            elem: '#date1'
        });

        //创建一个编辑器
        var editIndex = layedit.build('LAY_demo_editor');
=======
>>>>>>> c8ad49fbaef257483e8a1589ae68fed0e83ecb45

        //自定义验证规则
        form.verify({
            title: function(value){
                if(value.length < 5){
                    return '标题至少得5个字符啊';
                }
            }
            ,pass: [/(.+){6,12}$/, '密码必须6到12位']
<<<<<<< HEAD
            ,content: function(value){
                layedit.sync(editIndex);
            }
        });

        //监听指定开关
        form.on('switch(switchTest)', function(data){
            layer.msg('开关checked：'+ (this.checked ? 'true' : 'false'), {
                offset: '6px'
            });
            layer.tips('温馨提示：请注意开关状态的文字可以随意定义，而不仅仅是ON|OFF', data.othis)
=======
>>>>>>> c8ad49fbaef257483e8a1589ae68fed0e83ecb45
        });

        //监听提交
        form.on('submit(demo1)', function(data){
            layer.alert(JSON.stringify(data.field), {
                title: '最终的提交信息'
            })
            return false;
        });


    });
</script>

</body>
</html>